Provider Demographics
NPI:1306387980
Name:SOUTHWEST INFECTIOUS DISEASE SPECIALISTS LLC
Entity Type:Organization
Organization Name:SOUTHWEST INFECTIOUS DISEASE SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:KATTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-919-8387
Mailing Address - Street 1:7952 HORSE FERRY RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5973
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7952 HORSE FERRY RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-5973
Practice Address - Country:US
Practice Address - Phone:847-919-8387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty